Carried by World War I doughboys returning home from Europe, the newly virulent virus spread first from Boston to New York and Philadelphia before traveling West to infect panicked populations from St. Louis to San Francisco. But, of course, restaurants and people have never been evenly distributed. Restaurants are largely urban and the United States has become far more urbanized over the last century.
The first wave of the 1918 pandemic occurred in the spring and was generally mild. The sick, who experienced such typical flu symptoms as chills, fever and fatigue, usually recovered idraulico after several days, and the number of reported deaths was low. “The health department required families of the children recovering at home to either have a family physician or use the services of a public health doctor at no charge,” the Public Health Report article said. In mid-August, soldiers began reporting sick with pneumonia, but Army doctors did not think influenza was the underlying cause. As the outbreak progressed, they thought it was meningitis. With no quarantine, soldiers congregated in living quarters and mess halls.
Seattle’s mayor ordered his constituents to wear face masks. The first study found a clear correlation between the number of interventions applied and the resulting peak death rate seen. Perhaps more importantly, both studies showed that while interventions effectively mitigated the transmission of influenza virus in 1918, a critical factor in how much death rates were reduced was how soon the measures were put in place. It’s an indication of how much has changed since the Spanish flu pandemic a century ago that in those years, masks were mandatory. Variety reported on Nov. 22, 1918, that health officials in several cities ordered that they be worn in “every gathering place,” including stores, businesses, theaters and churches, before they initiated the general quarantine.
A newspaper clipping from 1918 documents a “public notice” from the city of Kelowna, British Columbia, announcing that schools, movie theaters, and other public places would be closed to prevent the spread of “Spanish Influenza.” Not every one of Copeland’s moves received a warm greeting. He came under fire for refusing to shutter schools and theaters throughout the city.
Once a potential pandemic starts, it will be difficult to get the necessary public and private buy-in, resources and authority until it is too late. I would agree with Tonya and Robert, there is an ever-present threat of a variant flu virus reeking havoc as many go unprepared for each flu season by not vaccinating, but also with a new, unknown pathogen. With the climate changing and the glacier ice melting to new low levels, bacteria, viruses and parasites previously encased in ice soon may be exposed to air, water, and humans. I am thankful for the diligent surveillance that the CDC and the WHO provides.
If social distancing was helpful then, it would have been made easier by the fact that absenteeism in schools soared during the pandemic, perhaps because of what one Chicago public health official called “fluphobia” among parents. The second study also shows that the timing of when control measures were lifted played a major part. Cities that relaxed their restrictions after the peak of the pandemic passed often saw the re-emergence of infection and had to reintroduce restrictions, says Neil Ferguson, D.Phil., of Imperial College, London, the senior author on the second study. In their paper, Dr. Ferguson and his coauthor used mathematical models to reproduce the pattern of the 1918 pandemic in different cities. This allowed them to predict what would have happened if cities had changed the timing of interventions. In San Francisco, which they found to have the most effective measures, they estimate that deaths would have been 25 percent higher had city officials not implemented their interventions when they did.
More than 100 soldiers at Camp Funston in Fort Riley, Kansas become ill with flu. Find information on coronavirus disease 2019 (COVID-19). They were probably thinking that theatergoers concerned enough to wear masks might not be in the right frame of mind to enjoy a show anyway. Within months it had killed three times as many as World War I and did it more quickly than any other illness in recorded history.
Robertson concluded that many students were being unnecessarily kept home by parents stricken with “fluphobia.” But then as now, parents had legitimate concerns about sending their children back. Some of the reasons the AAP has suggested children return to school in the fall has to do with their educational, social and developmental needs. This doesn’t even begin to account for the many issues related to child care and supervision that work-at-home parents have struggled with over the past several months. Officials in some communities imposed quarantines, ordered citizens to wear masks and shut down public places, including schools, churches and theaters. People were advised to avoid shaking hands and to stay indoors, libraries put a halt on lending books and regulations were passed banning spitting. Young children, people over age 65, pregnant women and people with certain medical conditions, such as asthma, diabetes or heart disease, face a higher risk of flu-related complications, including pneumonia, ear and sinus infections and bronchitis.
The pandemic did have a large impact on some sectors, however—notably manufacturing. Johnson and Mueller estimate 50 million deaths worldwide and provide estimates for several countries. The headline of the Oct. 11, 1918 Wisconsin State Journal states that all schools, colleges, churches, theaters and other public meeting places may be ordered to close. “The does actually have a lot of similarities because there were no vaccines, and your only hope really was one of two things. It was social distancing, and the development of some herd immunity as people contracted the disease and then recovered,” he said. Oshkosh would not reopen schools until Dec. 3, though officials barred sniffling students from attending.